Workshop or Panel Presenter Interest Form

The conference is on hold since May 2015. This form will be used when/if the conference is restarted.

Printable version of this form

(if your organization sells products and services see the vendor workshop information below)

Please provide the following information:

1. Proposed Workshop Title (subject to editing by T/MC)

2. Session Description - Please provide a clear, concise 50 word summary that tells participants what to expect from the workshop. This will be used on the conference website, invitation, and program book.

3. Provide a detailed description of your workshop, who it is intended to serve (leaders, volunteers, etc.), and one or two lessons participants might expect to take away from the workshop.

4. Provide a brief (100 word maximum) biography of each presenter and the organization you represent. If you or your organization are selling products and services, please review the sponsor agreement below.

5. To what level of experience is this presentation directed? :

6. If your workshop is focused on organizations working with specific age groups, please indicate which age levels the workshop targets:

K-5th grade 6th-8th grade 9th-12th grade

7. Audio Visual Needs: Please check only those items necessary for your presentation. The T/MC will make every effort to meet your request, but may need to discuss unusual requests on a case-by-case basis.

Flip chart and pens

Overhead projector and screen

Carousel slide projector

VCR and monitor

LCD projector


Note : The T/MC has limited capacity to provide LCD projectors and laptop computers. If you are not able to provide your own LCD projector or laptop, contact the T/MC for further guidance.

Presenter Release

By completing and submitting this online form, I agree to the following:

I agree that any photos taken of me during this event can be used on the Internet to help the T/MC and Tutor/Mentor Institute, LLC  promote future Conferences and tutoring/mentoring.

I agree that parts of my workshop can be filmed, and that parts or all of the video can be put on the Internet for promotional, educational, or motivational use.       Note: The T/MC will not make video copies of more than a few minutes of any speaker's presentation.